OPEN ACCESS FUNDHOLDING ENDOSCOPY IN THE PRIVATE-SECTOR

We conducted a comparative study of 150 patients referred for endoscop y to an NHS hospital and 150 patients referred to an open access schem e in the private sector for fundholding GPs. The concept of consultosc opy, whereby a consultant gastroenterologist gives an opinion at the s ame visit as the endoscopy is performed, is introduced. Results showed a similar number of normal studies (about 40%) were performed in each group, although the number of examinations showing serious pathology was significantly higher in the fundholding group (p<0.01). Patients s een in the fundholding scheme had less sedation, required fewer outpat ient appointments, and the GPs were given more advice on further manag ement than those seen in the non-fundholding group. We conclude that o pen access endoscopy in the private sector is a workable option and ma y result in work being transferred from NHS hospitals to the private s ector unless NHS hospitals review their working practices. The concept of consultoscopy is a useful development on traditional open access s ystems.